Endocrine Abstracts

Case history: 22 year old female presented with left sided hemiparesis following a generalised seizure; the blood glucose was 1.2 mmol/l. Corrective treatment restored cerebral function. In the preceding 6 months, she had symptoms of drowsiness on waking which corrected with sugary drinks and described tiredness with lethargy. There had been no reported change in appetite or bowel habits however, there had been a degree of weight loss during this period. During hospital admiss...

A 23-year-old woman presented in May 2018 with acute left-sided hemiparesis following increasingly frequent episodes of morning drowsiness with associated weight loss. She had no significant past medical history or family history. Brain imaging excluded intracranial pathology. Blood tests during a spontaneous hypoglycaemic episode (1.5 mmol/l) identified significant hyperinsulinaemic hypoglycaemia [insulin 392 pmol/l (18–173) and C-peptide 3913 pmol/l (370–1470)]. MR...

Introduction: The incidence and prevalence of GEP-NENs is rising worldwide. NENs represent the group off well differentiated neuroendocrine tumours (NET) and poorly differentiated neuroendocrine carcinoma (NEC). NETs can be divided into grade 1 (G1), grade 2 (G2) and grade 3 (G3) based on histological parameters. There exist several studies regarding survival data but these are mainly based on national databases.Aim: To describe the real world overall su...

Background: Small pancreatic neuroendocrine tumours (PNETs) present a management dilemma because of their uncertain natural history. Some clinicians believe that lesions <2 cm are indolent and can be managed with surveillance. By contrast, the most recent WHO classification system regards all PNETs as potentially malignant.Aim: To assess the malignant behaviour of small PNETs in a large, retrospective, multicentre patient cohort.<p class="abstext...

Background: The lack of relevant in-vivo and in-vitro models has precluded investigations of the pathophysiology of metastatic NENs. Organotypic tumour slices retain the complexity of tumours in-vivo without extensive manipulation of the tissue. The aims of this study are to understand the utility of precision cut slice technology to develop an immunocompetent model of metastatic GEP NENs to test new therapeutics and elucidate immunological, molecula...

Accumulating evidence suggests that the immunological landscape plays a key role in the progression of neuroendocrine liver metastases (LM-NENs), which is often characterised by immune cell infiltration. Anti-tumour functions of infiltrating lymphocytes are often silenced through hyper-expression of inhibitory checkpoint receptors (CRs) such as PD-1, but favourable outcomes with anti-PD-1 therapy have been low. Recently, functional soluble (cell-free) CRs beyond PD-1 have been...

Background: Pancreatic neuroendocrine tumours (panNETs) are rare tumours (prevalence 4/100,000). Diagnosis and staging of panNETs requires biochemical screening, cross-sectional imaging (with CT/MRI), endoscopic ultrasound (EUS) and where available, functional imaging using 68Ga-labelled synthetic octreotide analogues using PET-CT due to its reported higher sensitivity and specificity.Methods: A retrospective, electronic case note study was ca...

Background: Pancreatic neuroendocrine tumours (panNETs) may arise as part of an underlying genetic condition such as multiple endocrine neoplasia type 1 (MEN type 1). The value of functional imaging using 68Ga-labelled synthetic octreotide analogues using PET-CT has not been extensively evaluated in patients with MEN1 to determine its value.Methods: We investigated the effect of 68Ga-based PET-CT imaging on patient management in pat...

Introduction: Multi-modal therapy for adrenocortical carcinoma (ACC) includes surgery, therapy with the adrenolytic agent mitotane and systemic chemotherapy. Achievement of therapeutic mitotane concentrations (≥14 mg/l) has been related to improved outcomes.Aim: To evaluate the effectiveness of a defined* high dose protocol mitotane therapy in patients with advanced ACC (stages III and IV).Methods: Review of patients presenti...